Witnessing and reporting resident abuse.

[wjg2882, ASN]

I was an LPN for a couple of years and now an RN for a little over a year. I just started at a new facility 3 days ago and I don't know many of the nurses yet because I work nights. The first 2 days I worked 2nd shift on the 3rd floor at a LTC facility. The 3rd day I was working 3rd shift on the 2nd floor which is where I will be working most of the time. At the end of my shift I ran upstairs to clock out on the 3rd floor. I witnessed a nurse trying to administer meds to a resident that I had taken care of the previous 2 days. This resident has behavior issues and refuses meds and care which she has the right to do. Anyway, the nurse was trying to force the spoon of crushed meds in pudding into the resident's mouth. The resident kept telling her she didn't want it. The nurse then bent down and in the resident's face loudly asked her repeatedly did she want breakfast. When the resident finally said yes, the nurse told her to take the meds then. The resident again said she didn't want it. When the nurse realized I was watching her, she went around behind the resident's wheelchair and started wheeling her towards the dining room and I heard the STNA ask her what she was going to do and the nurse said, "Get her to take this medicine one way or another." I left work and plan on talking to the Administrator about the incident. I don't know what this nurses name is and like I said, I just started at this facility and I don't want to be thought of as a trouble maker but I feel this is definitely abuse and I can't let it go. If it were my mother, I would be furious! I feel like this about all the residents, even those with issues. The DON was just let go Friday so I need to go the Administrator but I want to know how everyone else would approach the issue. Thanks for any advice!

[kbrn2002, ADN, RN]

Contact your Ombudsman for advice. You can do so anonymously if you believe reporting to the administrator would a) do no good or b) be detrimental to your job.

[Nascar nurse, ASN, RN]

You should have reported it immediately to whoever is in charge...I would just about bet that is your policy. Now you need to notify the administrator ASAP. It is his/her legal responsibility to do a full investigation (this is per the federal regulations).

Just as an FYI - by not reporting this immediately a surveyor could easily say that you allowed the abuse to potentially continue. This type of situation must be dealt with immediately.

[elprup, BSN, RN]

Scary.

[mlbluvr]

Sad to say for you- but as Nascar said, you failed to intervene to stop not only what you yourself called abuse, but what might well be considered an actual asault, in your state. I'm scared, like elrpu said, but for you if there is an investigation, or forbid, actual physical harm was caused. You can't witness what you consider abuse, based on your plan to 'tell the administrator' at a later date. Also, the fact that the DON was 'let go' (whatever that means), tells me there is a serious problem in that place, anyway.

[mlbluvr]

If you don't report what you witnessed, you're guilty of allowing what you yourself labeled 'abuse', to possibly continue, unchecked. A clear violation of nurse practice act anywhere, as well as laws. If you do report it- here's what I anticipate: Your ADM will tell you to complete an incident report, while he and others go to check the status of that patient, call the abusive nurse to come in immediately, call the family to report that one of his nurses claims she witnessed abuse and failed to call him or the police, etc., call the doctor to ask for an evaluation of the patient, and then fire you, to cover himself, for your failing to follow either policy, or law, or nurse practice act directives on abuse policy. Then, he'll probably report you to the BON. It's called CYA- the main requirement of a LNHA or DON position.It's not pretty, in any event. I'm sorry you lacked the instinct to jump into the fray to protect that patient. Ugly situation.

[sallyrnrrt, ADN, RN]

first i would of interveined, and reminded the nurse the resident has the right too refuse.......probably stopping the abuse.......i know this is easier for me as a 41yr RN, and you are a new nurse, i am not belittling you just enabling you to advocate for the resident, this needs to be reported......

i hope there is more than you as a witness, residents rarly colaborate the accusation out of fear of retalliation, honest.... i have had state tell me if resident does not or is not able to collaborate and I was the only witness, and the offender denies, which they always do, they could not cite........as it was a hesaid she said issue....i was devastated as an adon, i had witnessed fragrant resident abuse, resident would not admit what was done to him, and cna denied.......however my DON placed the seasoned CNA on extensive probation and monitoring, she developed into a super CNA, and still today does a fine job as a restorative CNA.......please report

[chrisrn24]

I don't know why nurses push meds so much. If I'm passing meds and the resident doesn't want it I don't stick around and try to get them to take it. Unless it is something serious.